Methadone
and Buprenorphine
www.drugpolicy.org
We are the Drug Policy
Alliance and we envision
a just society in which the
use and regulation of drugs
are grounded in science,
compassion, health and
human rights, in which
people are no longer punished
for what they put into their
own bodies but only for
crimes committed against
others, and in which the
fears, prejudices and punitive
prohibitions of today are
no more.
ISBN: 1-930517-27-0
3 Acknowledgments
4 Introduction
6 Dependency
8 What is Methadone?
10 Buprenorphine
11 Maintenance
13 After Methadone
14 Myths & Facts
16 Drug Interactions
18 Your Other Doctors
19 Methadone & Women
21 Storing Methadone
22 Concerns about Overdose
25 In Case of Overdose
26 Detoxification
28 Methadone & Pain
29 Driving
30 Traveling with Methadone
32 State Substance Abuse Agencies
33 Other Resources
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Introduction
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Dependency
Opioids have been used for thousands people with a long history of opioid
of years, and it has long been known problems have experienced changes
that many people who have become to the part of their brains that allows a
dependent on opioids have extreme person to feel and function normally.
difficulty permanently ending their This part of the brain makes and uses
use of them. its own natural opioids.
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What is Methadone?
Methadone is a long-acting,
synthetic drug that was first used in
the maintenance treatment of drug
addiction in the United States in
the 1960s. It is an opioid “agonist,”
which means that it acts in a way
that is similar to morphine and other
narcotic medications.
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Buprenorphine
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Methadone won’t control
a person’s desire to
get high, but an adequate
dose of methadone
should prevent the
overwhelming physical
need to use street opioids.
Many people who must take staying opioid free over the long
medications every day get tired of term is the harder challenge. Studies
doing so. This is especially true of find that people who have long
patients on methadone maintenance histories of trying and failing to live
because, in the United States, almost without opioids will probably not be
all methadone patients are also able to stay abstinent for long.
required to make frequent visits to
a clinic to receive their medication. It isn’t yet possible to predict who
For many reasons, most methadone will be able to live life without opioids,
maintenance patients decide at but it doesn’t seem to depend on how
some point that they want to stop “together” you are. If you are detoxing
taking methadone. and find that you are craving opioids,
or you have finished detoxing and
If you do choose to leave mainte- you are always thinking of opioids,
nance, your provider should reduce then perhaps maintenance should
your dose at the speed you feel be part of your life.
comfortable with. If it is slow enough
you should not experience major
physical withdrawal symptoms.
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Myths & Facts
Fact: Methadone does not “get into Fact: People have been taking
the bones” or in any other way cause methadone for more than 30 years,
harm to the skeletal system. Although and there has been no evidence that
some methadone patients report long-term use causes any physical
having aches in their arms and legs, damage. Some people do suffer
the discomfort is probably a mild some side effects from methadone
withdrawal symptom and may be – such as constipation, increased
eased by adjusting the dose sweating, and dry mouth – but these
of methadone. usually go away over time or with
dose adjustments. Other effects,
Also, some substances can cause such as menstrual abnormalities
more rapid metabolism of methadone and decreased sexual desire, have
(see pages 16-17 for a list of medica- been reported by some patients
tions that interact with methadone). but have not been clearly linked to
If you are taking another substance methadone use.
that is affecting the metabolism of
your methadone, your doctor may Myth: Methadone is worse for your
need to adjust your methadone dose. body than heroin.
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Drug Interactions
If your methadone
dosage doesn’t feel right,
it probably isn’t right.
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Your Other Doctors
• If you are having surgery for which • It is illegal for your methadone
you may be put to sleep, the provider to communicate with your
anesthesiologist might use a type primary-care doctor or anyone else
of medication that will cause abrupt without your written permission.
methadone withdrawal. Be sure you (Title 42 of the Code of Federal
know which medications interact Regulations Part 2 [42CFR part 2]
with methadone (see pages 16-17) protects against disclosure of drug
– even if your doctors know that you treatment records.)
are taking methadone.
Ideally, though, open communica-
tion among all the doctors who are
treating you may assist you in getting
the best possible health care.
Is it true that women sometimes You may have heard that you should
stop getting their periods when not take methadone when pregnant.
they begin taking methadone? This is not true.
Yes, but there are also many other • Methadone is not harmful to the
reasons why women’s periods developing fetus – but detoxing is.
become irregular or stop: • Methadone is the treatment of choice
• Pregnancy for heroin and opioid dependency
• Stress during pregnancy.
• Poor diet • The effects of methadone on
• Weight gain and loss pregnancy have been widely studied.
• Menopause • Methadone has been used
• Other medical problems successfully during pregnancy.
• Other medications • When properly prescribed for
pregnant women, methadone
Remember: provides a non-stressful environment
• You can still get pregnant even if you in which the fetus can develop.
don’t get your period. • Taking methadone during pregnancy
• You can conceive and have normal may prevent miscarriage, fetal
pregnancies and normal deliveries distress, and premature labor.
while you are receiving methadone. • Decreasing the dose of methadone
during the first trimester increases the
risk of miscarriage.
• During pregnancy, your dose should
be sufficient to avoid cravings, avoid
street drugs, and prevent withdrawal.
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Methadone & Women (cont.)
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Concerns
About Overdose
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Concerns About Overdose (cont.)
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Detoxification
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Methadone & Pain
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Traveling with Methadone
Whichever country you travel to, Each patient will have to weigh
you will need to decide whether this decision very carefully. Many
you will carry your own methadone methadone patients have traveled
(where permitted) or find a metha- to various parts of the world without
done provider there who will treat you experiencing any problems.
(if one is available).
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State Substance
Abuse Agencies
Alabama 334.242.3961 Nebraska 402.471.7818
Alaska 907.465.2071 Nevada 775.684.4190
Arizona 602.542.1000 New Hampshire 603.271.6110
Arkansas 501.686.9866 New Jersey 609.292.5760
California 800.879.2772 New Mexico 505.827.2601
Colorado 303.866.7480 New York 518.473.3460
Connecticut 860.418.7000 North Carolina 919.733.4670
Delaware 302.255.9399 North Dakota 701.328.8920
District of Ohio 614.466.3445
Columbia 202.727.8857 Oklahoma 405.522.3619
Florida 850.487.2920 Oregon 503.945.5763
Georgia 404.657.2331 Pennsylvania 717.783.8200
Hawaii 808.692.7506 Puerto Rico 787.764.3795
Idaho 208.334.5935 Rhode Island 401.462.4680
Illinois 800.843.6154 South Carolina 803.896.5555
Indiana 317.232.7800 South Dakota 605.773.3123
Iowa 515.281.4417 Tennessee 615.741.1921
Kansas 785.296.6807 Texas 512.206.5000
Kentucky 502.564.2880 Utah 801.538.3939
Louisiana 225.342.6717 Vermont 802.651.1550
Maine 800.499.0027 Virginia 804.786.3906
Maryland 410.402.8600 Washington 877.301.4557
Massachusetts 617.624.5111 West Virginia 304.558.2276
Michigan 517.335.0278 Wisconsin 608.266.2717
Minnesota 651.582.1832 Wyoming 307.777.6494
Mississippi 877.210.8513
Missouri 573.751.4942
Montana 406.444.3964
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The Drug Policy Alliance Please join our fight for the rights
published About Methadone and and dignity of methadone patients
Buprenorphine to help patients make and the millions of others who
healthy and informed treatment suffer the consequences of the
decisions with their doctors. As part failed war on drugs. Join the
of our broader mission, we also seek Drug Policy Alliance today.
to end the prejudices and policies
that cause discrimination against all To become a member and help end
people in maintenance therapies. the war on drugs, please contact:
DPA AM 0710
About Methadone and Buprenorphine